Pure Life Medical Group LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PURE LIFE MEDICAL GROUP LLC

Practice address

3637 Del Prado Blvd S Ste 305
Cape Coral, FL 33904-7199

Phone

(239) 269-8767

NPI assigned

Oct 27, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Yenisleydis Padron

Title

Ceo

Phone

(239) 269-8767

Specialties & licenses 1

Addresses

Other names 1

• Pure Life Medical Center Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Saiful Islam, M.D.

  • Family Medicine Physician
  • Ft Myers, FL
  • NPI 1548261613
  Medicare reassignment NPD
• Idelmys Diaz, RBT

  • Behavior Technician
  • Fort Myers, FL
  • NPI 1497244339
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1666828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768867200000",
    "number": "1275250433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3637 DEL PRADO BLVD S STE 305",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339047199",
            "telephone_number": "239-269-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3637 DEL PRADO BLVD S STE 305",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339047199",
            "telephone_number": "239-269-8767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE LIFE MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-27",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A",
        "authorized_official_last_name": "PADRON",
        "authorized_official_first_name": "YENISLEYDIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "239-269-8767"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pure Life Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Keren Pupo Losada, RN
• Irais Pupo Pupo, RBT
• Alfred Pupo
• Rey Moises Pupo
• Pupo'S Lovable Family Inc.
• Susan Lynn Purnell
• Puzzle Therapy Services, Inc.
• Barbara D Pyatt, OT
• Jiatian Qu
• Quality and Safety Transport

• Family Medicine Physician in Cape Coral, FL
• Providers in Cape Coral, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.